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By LGBT Aging Advocacy (Connecticut) and CT TransAdvocacy Coalition

A substantial number of physicians serving Medicare participants do not know the sexual orientation or gender identification of the LGBT elders they care for, although this can be a critical factor for their patients’ health and health care. This is particularly important to keep in mind as the current generation of older LGBT people were usually not able to express their true selves.

Indeed, the 2014 SAGE report Out and Visible: The Experiences and Attitudes of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults, Ages 45-75 reports that 40% of LGBT persons in their 60's and 70's say that their health care providers do not know their sexual orientations. (LGBT Aging Advocacy, Connecticut.)

Medicare coverage is based on health care needs.  Sexual orientation should be irrelevant to coverage determinations. However, sexual orientation and activities can be relevant to one’s health and health care needs. It’s important for providers to reach out to their patients in appropriate and inclusive ways to discuss these important aspects of their lives and health. Training is available through the National Resource Center on LGBT Aging.   

So too, transgender people should also be able to receive health care and Medicare coverage based on their medical needs, not on their gender identification.  “Treat the body, not the gender” is how transactivists summarize the distinction. Medicare recently rescinded its coverage rule that denied coverage for gender identification-related surgery and services. 

Medicare coverage is available for most reasonable and necessary health care, but obtaining access to coverage and quality health care depends on providers doing their part to create an environment in which LGBT persons are able to be fully themselves in an accepting environment.

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